HomeMy WebLinkAboutFood Service Establishment Inspection 30 (4) ENS-106•Rev.11105 INSPECTION REPORT STATE OF CONNECTICUT 0114OUTINE.INSPECTION ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ OTHER
410 Capitol Avenue,MS#11 FDP,Hartford,CT 06134
NAME OF ESTABLISHMENT ^'7
ESTABLISHMENT Us A lia S CLASS L�
STREET "—� TOWN
ADDRESS
OWNER or INSPECTION
OPERATOR DATEandTIME
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corrected by the date specified below.
SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insects/rodents 12
nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket,if used insects/rodents
24 Sanitization rinse(hot water-chemical) 2
FOOD PROTECTION 25 Clean wiping cloths 1 FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 2 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and
transportation 27 Nonfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required 1
equipment clean 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 Equipment/utensils,storage,handling 1 47 Mats removable,good repair,clean
temperature,thermometers provided
5 Potentially hazardous food properly thawed 2 48 1 Exterior walking,driving surfaces, 1 -
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean
not re-served 29 Water source adequate,safe 4 49 Walls,ceilings attached,equipment properly 1
7 ood protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
display,service&transportation provided as required surfaces as required.
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL cleaning equipment properly stored
9 Handling of food minimized 2 31 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 Proper disposal of waste water 1 LIGHTING&VENTILATION
11 Toxic items properly stored,labeled,used 14 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors 1
PERSONNEL 33 1 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required
12 1 Personnel with infection restricted 4 34 1No cross connection,back siphonage,backflow 4
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 1 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
personnel hands washed,clean installed
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insectlrodent harborage,no unnecessary articles
CONSTRUCTION &INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1
16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry
maintained,installed,located tissue waste receptacles provided
57 Clean/soiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOSALI I(except guide dogs)
18 Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean SMOKING PROHIBITED
20 Dishwashing facilities approved design,adequately 2 40 Storage arealrooms,enclosures- 59 1 Smoking prohibited,signs posted at each 3
constructed,maintained,installed,located properly constructed,clean entrance
1
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
4 3 Y
1 t RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
62 Written documentation of training program 2
Signature Person in charge
TOTAL RATING Date Corrections Due
SIGN D(Inspector
DESCRIBE EF CI S 0?6(f6NIINUATION SHEETS
DISTRIBUTION:I"-White-Health Departnn.ent 2°d-Yellow-Owner/Operator
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INSPECTION REPORT STATE OF CONNECTICUT We
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
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INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) A V
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager